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SGLT2 Inhibitors Lowers Gout Risks in Type 2 Diabetes

A population-based cohort has demonstrated that sodium-glucose cotransporter-2 inhibitors (SGLT2i) use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients with type 2 diabetes (T2D). 

SGLT2i agents have become mainstays in the care of type 2 diabetes (T2D), cardiovascular and renal patients, and they have also shown ability to lower serum urate levels. Hence this study compared gout outcomes when metformin treated patients were either given a sulfonylurea (eg, glyburide) or SGLT2i's. The primary outcome was an incident gout diagnosis. Secondary outcomes included gout hospitalizations, gout flare rates and major adverse cardiovascular events (MACE).

From a total of 34 604 (propensity score matched) T2D adults starting either SGLT2i or sulfonylurea, rates of incident gout were lower with SGLT2i initiators:

  • SGLT2i: 4.27 events per 1000 person-years (HR 0.62; 95% CI, 0.48-0.80)
  • Sulfonylurea: 6.91 events per 1000 person-years

SGLT2i use also had fewer recurrent gout flares (rate ratio, 0.67; 95% CI, 0.55-0.82) and fewer MACE (HR 0.87; 95% CI, 0.77-0.98).  SGLT2i was associated with a lower risk of heart failure (HR, 0.53). 

In this population-based cohort study of 34 064 adults with T2D, SGLT2i use (vs sulfonylureas) was associated with lower risk of incident gout, major adverse cardiovascular events and heart failure, and lower rates of recurrent flares.


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The author has no conflicts of interest to disclose related to this subject